Patient killing at state psychiatric hospital is second since 2010

For the second time in just over a year, officials at the state's maximum-security mental hospital will review procedures after a patient was charged with killing his roommate.

The killing of David Rico-Noyola, 22, at the Clifton T. Perkins Hospital Center is believed to be just the second homicide in the facility's 50-year history, but it comes 13 months after a similar incident. The death of patient Susan Sachs in September 2010 prompted a critical review that found workers were inattentive, slept on the job and lied about checking on patients.

On Friday, police charged 24-year-old Vitaly Davydov, a Montgomery County man who killed his psychiatrist in 2006, with the death of Rico-Noyola, with whom he shared a room at the Howard County facility. Davydov was returned to the facility after being charged, police said.

W. Lawrence Fitch, director of forensic services for the Maryland Department of Health and Mental Hygiene, said another internal investigation of policies and procedures was under way in the wake of Friday's killing.

"After the incident last year, people painstakingly went over everything that goes on in the hospital. Changes were made, and now this has happened. It's a difficult thing," Fitch said.

Fitch said he was unable to comment on specifics because the police and internal investigations are in their early stages.

Shortly before 2:30 p.m., Davydov came out of the room he and Rico-Noyola shared in a maximum-security area of the hospital and asked a security guard for help, police said. Hospital staff then found Rico-Noyola on the floor, suffering from trauma to his body and head. He was bleeding, and spokesman Greg Shipley said an autopsy showed he suffered from blunt-force trauma likely inflicted by a person's hands.

A nurse had checked their room 30 minutes before the attack and found nothing out of the ordinary, police said.

In August, the Department of Health and Mental Hygiene deemed Rico-Noyola incompetent to stand trial in the death of his mother in 2008. Court records show another competency hearing was scheduled for next month.

Fitch said that only a small percentage of Perkins' 200 patients are awaiting trial like Rico-Noyola, but all undergo the same screening procedures. "The legal status is less significant than their clinical status and their risk factors," he said.

It's also common for patients to share rooms, though there are single rooms within the facility.

In 2007, Davydov was found not criminally responsible for the fatal beating a year earlier of Rockville psychiatrist Wayne S. Fenton, a renowned specialist in the treatment of schizophrenia.

A judge concluded that severe mental illness prevented Davydov from realizing that he was committing a crime and ordered him committed to Perkins until he was determined to no longer be dangerous, The Washington Post reported.

In last year's killing, El Soundani El-Wahhabi, 51, was charged with murder in the Sept. 25 death of Susan Sachs, who was found dead in her bed at the hospital. Since 2008, two other deaths, one accidental and the other health-related, also raised questions about staffing and operations at the facility.

In response to the review of Sachs' death, officials said in February that they had stepped up staffing of the medium-security ward where Sachs was killed, and increased hospital oversight of night-shift nurses and security staff.

Advocates for psychiatric patients were critical, however, saying there had been no changes of policy or procedures. Around the same time the review was released, the hospital announced that the hospital's chief executive was retiring.

Still, an official with the National Association of State Mental Health Program Directors told The Baltimore Sun last year that such tragedies were not unusual at hospitals that treat violent patients and said Perkins is considered a model forensic psychiatric hospital.

After nearly six months of back-and-forth, a bill creating a set of nutritional guidelines for the food and drink sold in Howard County government vending machines was voted, for a final time, into law today.